The March 2022 Medicare Benefits Schedule (MBS) files are available on the March 2022 Downloads page
From 1 March 2022 there will be a number of changes to the MBS. These changes include implement the Government’s response to recommendations form the MBS Review Taskforce (the Taskforce) regarding pain management, anaesthesia, gynaecological and midwifery services. There will also be changes to Transcatheter Aortic Valve Implantation services and a fee alignment for GP and OMP telehealth and telephone services.
A number of changes to the General Medical Services Table (GMST) will be implemented through the Health Insurance Legislation Amendment (2021 Measures No. 4) Regulations 2021 (the Regulations).
Changes to pain management services
From 1 March 2022, some of the MBS items for pain management services are changing to align with contemporary best practice. The changes are a result of the MBS Review Taskforce recommendations for pain management and extensive consultation with stakeholders.
These changes include revision of item terminology to align with best clinical practice, introducing new services and revising existing services to minimise unnecessary treatments from being performed and administrative changes.
These changes will improve safety and health outcomes by ensuring patients receive services that align with current best practice guidelines and discourage unnecessary or out-of-date treatments. Changes will be made to nerve block, spinal injection and implanted device procedure MBS services and include 7 new items, 42 amended items and 3 deleted items.
Changes to anaesthesia services
From 1 March 2022, there will be changes to align anaesthesia items with contemporary clinical practice and ensure appropriate patient access. These changes include the introduction of one new item for the initiation of management of anaesthesia in association with hip revision surgery, amending four items to clarify their clinical intent, and including a rule which requires the start and end times for a service under the time component anaesthesia items 23010 to 23146 to be documented in writing.
Changes to gynaecological services
Changes to gynaecology services will be implemented from 1 March 2022. These changes include the amendment of 68 items, the introduction of 13 new items and the removal of 32 items from the MBS. The changes will:
- align services with current clinical best practice and clarify the appropriate use of the items;
- remove outdated and obsolete items that do not reflect current or best clinical practice;
- increase the benefit amount for the insertion of intrauterine devices to encourage the use of long-acting reversible contraceptives in Australia;
- amend assisted reproductive technology (ART) items to expand clinical options and promote a higher value of care for those undertaking in-vitro fertilisation;
- amend general gynecology items and increase the Schedule fees of gynaecology items to address the complexity of treating endometriosis;
- amend miscarriage items to allow these procedures to be performed under sedation, and outside a hospital setting; and
- Ensure that new technologies and techniques are being remunerated, such as the inclusion of laparoscopic procedures and laser or cryotherapy ablation for cancer services were appropriate.
Midwife and Nurse Practitioner Services
From 1 March 2022, there will be changes to three existing midwifery services items and the introduction of four new items for participating midwife attendances. These changes will implement the Government's response to the Participating Midwives Reference Group (PMRG) recommendations 4, 5 and 7 of the MBS Review Taskforce's Report on Primary Care. There will also be administrative amendments to update terminology that is outdated.
Transcatheter Aortic Valve Implantation
The purpose of the 1 March 2022 changes to Transcatheter Aortic Valve Implantation services (TAVI), is to amend MBS item 38495 and introduce new item 38514. These changes reflect the two separate clinical populations that have been supported by the Medicare Services Advisory Committee (MSAC) recommendations for the TAVI procedure.
Item 38495 will be amended to prescribe that the service applies to a patient at high risk of complications for surgery and apply a co-claiming restriction against new item 38514. This change also clarifies that a service under item 38514 must be provided in a hospital setting only.
New TAVI item 38514 is introduced for the treatment of symptomatic severe aortic stenosis in a patient at intermediate risk of complications for surgery. A service under 38514 must include all intraoperative diagnostic imaging provided for the TAVI procedure and must be provided in an eligible hospital on an eligible patient by an eligible practitioner.
From 1 March 2022, item 38276 will be amended to expand access to patients who have an absolute and permanent contraindication to oral anticoagulation. The patient’s condition must be confirmed in writing by a medical practitioner who is independent of the practitioner rendering the left atrial appendage closure service. This change was recommended by MSAC
Administrative changes to align GP Telehealth and Phone fees
From 1 March 2022, there will be amendments to a number of general practice remote service fees that were originally created in response to the COVID-19 pandemic. These services are being continued following the Government’s commitment to the need for these services and will have an administrative amendment to change the benefit calculation from 85% to 100% of the fee. This is an administrative change that reduces the fees of those items, so the benefit paid for the service remains unchanged. These changes include all GP and medical practitioner (excluding specialist and consultant physician) items in Group A40, A41, A42, A43 and A45.